Intubation device

ABSTRACT

The present invention is a device and a method of performing endotracheal intubation. In a preferred embodiment of the invention, the intubation device comprises an endotracheal tube having a forward open end, a rearward open end, and an inner bore there between. The endotracheal tube is provided with a fitting for inserting longitudinally within the rearward end and an adaptor for connecting to a respirator or other ventilating apparatus. A stylet is telescopingly positioned within the inner bore and extends outwardly from the forward open end and includes a longitudinally extending soft and flexible guide portion. The stylet is adapted to move outwardly from the forward open end of the endotracheal tube such that during insertion of the endotracheal tube into the trachea of the patient the guide portion is positioned within the trachea and operates to direct the endotracheal tube within the trachea.

BACKGROUND OF THE INVENTION

This invention relates to an intubation tube and more particularly, to anew and improved intubation device having a stylet for use in placing anendotracheal tube into the trachea of a patient.

Intubation devices, such as oral-endotracheal tubes, are utilized in awide variety of medical situations to provide an unobstructed conduit toa patient's trachea in which oxygen, medications and therapies can bepassed. In most situations in which medical attention is needed, medicalpersonnel will first determine the ability of the patient to maintaintheir airway. Often these emergent evaluations are performed byindividuals having inadequate training and knowledge in airwaymanagement. The inability to secure an airway and provide a route ofventilation in someone whose airway is threatened, compromised, orobstructed can quickly result in irreversible brain damage and death.

Placement of an intubation device, such as an endotracheal tube, intothe tracheobronchial tree of a patient is accessed via the nasal or oralopening. In a few select situations nasal intubation is indicated,however, the vast majority of airways are secured via the oraltrachealroute. Placement of an endotracheal tube, however, is often found to bea difficult procedure, even by well-trained, experienced personnel. Thisdifficulty can be attributed to the anatomical variations or theencountered situation in which the airway needs to be secured. Further,during the process of placing an endotracheal tube into the trachea of apatient, it is not uncommon that only minimal visualization of thelaryngeal anatomy can be obtained thereby increasing the chances thatesophageal intubation can occur. Thus, the ability to “blindly” place anendotracheal tube properly into the trachea of a patient is directlyproportional to the medical personnel's experience and the availabilityof additional intubation devices available.

Endotracheal tubes are generally formed of soft, pliable plasticmaterials that increase in plasticity in the warm humidified airencountered when passing through the hypopharynx, thereby increasing thedifficulty of placing an endotracheal tube through the glottic openingeven under the most optimal visualization. Making the endotracheal tubeout of a stiffer material, however, is not an acceptable alternativebecause it would cause excessive trauma to the nasal or throat tissue asthe laryngeal and surrounding mucosa is extremely sensitive tomanipulation. This can result in significant swelling and decreasedvisualization, which prevents or hinders oral tracheal intubationthereby placing the patient's life in great jeopardy. To overcome thisproblem, intubation devices often have a removable stylet made out of asomewhat malleable material that is telescopically placed within theendotracheal tube and has a sufficient amount of stiffness in order tomaintain the tubes desired contour and to aid in tracheal intubation.

The stylet, which has gained the most acceptances for oral intubation,is a “pre-bend” stylet made of a rigid, malleable material such asrubber or plastic coated metal. Typically, during the intubationprocess, the medical personnel performing the process inserts the styletinto the endotracheal tube and folds one end of the stylet around theoutboard end of the tube. The tube and the stylet are then molded toapproximately conform to what is believed to be the route of passage tothe laryngeal inlet. With the help of a laryngoscope, the medicalpersonnel inserts the stylet and the endotracheal tube into thepatient's mouth and hypopharynx until it reaches the patient's trachea.If needed, after visualizing the hypopharynx, the tube and stylet can beremoved and the contour adjusted if necessary. Unfortunately, it isdifficult for medical personnel, even after extensive training, topredetermine the proper contour that the endotracheal tube should bemolded to for placement into the patient's trachea. Accordingly, it isnot uncommon to fail in the first attempt to intubate the patient. Insuch an event, medical personnel must then remove the tube and thestylet from the patient, adjust their contour, re-ventilate the patient,and reinsert the now adjusted tube and stylet into the patient. Suchremoval and reinsertion of the endotracheal tube and stylet results invaluable time lost and may also result in damage to the patient's softairway tissue thereby significantly increasing the likelihood of loss ofvisualization of the laryngeal anatomy and the time for oxygen delivery.Further, sterility of the endotracheal tube may be sacrificed when theuser grasps the stylet to rebend the stylet into the proper contour.

In order to overcome some of the problems encountered with suchintubation devices, mechanical guides have been developed to assistintubation of endotracheal tubes. It has been found that such mechanicalguides are typically difficult to manipulate with one hand and do notallow for delicate control or provide the proper sensitivity necessaryto intubate a patient quickly with a minimum amount of trauma tosensitive tissue. Accordingly, such mechanical guides have not met withwidespread commercial success or recognition in the medical field andthe malleable or “prebend” stylet is still the predominate oralintubation aid used. Further, such guides are also typically formed frommaterials that are sufficiently rigid to maintain a desired contour.Accordingly, such guides have been found to cause trauma to sensitivetissue.

It is therefore desirable to have an intubation device that can bequickly and easily inserted to form an unobstructed conduit to apatient's trachea in which oxygen, medications and therapies can bepassed, that reduces the likelihood of trauma to the sensitive nasal orthroat tissue of the laryngeal and surrounding mucosa, that reduces thechances of compromising the sterility of the device, and which can berelatively inexpensive to manufacture.

SUMMARY OF THE INVENTION

The present invention is a method of performing endotracheal intubationand new and novel intubation device for performing the method. In apreferred embodiment of the invention, the intubation device for use inmedical intubation comprises an endotracheal tube having a forward openend and a rearward open end and an inner bore there between. Theendotracheal tube is provided with a fitting having a neck portion forinserting longitudinally within the rearward open end and an adaptor forconnecting to a respirator or other ventilating apparatus. A stylet isslidably and telescopingly positioned within the inner bore and includesa proximal end that extends outwardly from the rearward open end andadaptor and a distal end having a longitudinally extending soft andsemi-flexible guide portion. The stylet is adapted to slide or moveoutwardly from the forward open end of the endotracheal tube such thatduring insertion of the endotracheal tube the guide portion movestowards the larynx until it is positioned within the trachea.Thereafter, the endotracheal tube telescopingly slides or movesforwardly over the stylet and guide portion which operates to direct theendotracheal tube into proper position within the trachea. The styletcan then be removed by withdrawing the stylet rearwardly out through therearward open end of the endotracheal tube and fitting. The endotrachealtube can then be attached to a respirator or other ventilating apparatususing the adaptor.

In another preferred embodiment of the invention, the endotracheal tubeis provided with an inflatable bladder or balloon that when inflatedprevents ventilation gas flowing through the endotracheal tube fromescaping outwardly from the trachea.

In another preferred embodiment of the invention, the stylet is formedfrom a semi-flexible metal rod or wire.

In another preferred embodiment of the invention, the semi-flexiblemetal rod is formed from copper.

In another preferred embodiment of the invention, the metal rod iscoated by a soft and pliable plastic, such as a polyethylene material.

In another preferred embodiment of the invention, the stylet is taperedto minimize the lip formed between the forward open end of theendotracheal tube and the stylet.

In another preferred embodiment of the invention, the forward open endof the endotracheal tube includes a cuff to minimize the lip formedbetween the forward end of the endotracheal tube and the stylet.

In another preferred embodiment of the invention, the endotracheal tubeincludes an inner sleeve adapted for receiving stylet to permit theendotracheal tube and stylet to be bent into a desired contour withgreater unity.

In another preferred embodiment of the invention, the intubation deviceof the present application further comprises means for inducingcurvature to the endotracheal tube and stylet.

In another preferred embodiment of the invention, the stylet includes alongitudinally extending hollow core having a proximal open end and adistal open end adapted to connect to a standard oxygen supply.

In another preferred embodiment of the invention, the stylet includes achemiluminesent light effective for aiding in the intubation of thepatient.

In a preferred embodiment of the invention the method of performingendotracheal intubation of a patient, the method comprises the steps offirst inserting an endotracheal tube and a stylet of an intubationdevice through the mouth of a patient and down the throat towards thelarynx. The stylet is then slid or moved outwardly from the endotrachealtube such that the soft and semi-flexible guide portion of the styletenters the trachea. The stylet then operates to direct the endotrachealtube into proper position within the trachea. The stylet is then removedout through the rearward open end of the endotracheal tube and theendotracheal tube is then attached to a respirator or other ventilatingapparatus.

In another preferred embodiment of the invention the curvature of thestylet is adjusted to a desired contour for insertion into the tracheaof the patient.

In another preferred embodiment of the invention, the stylet having achemiluminesent light is bent to activate the chemiluminesent light.

In another preferred embodiment of the invention, an inflatable bladderor balloon is inflated to prevent ventilation gas from flowing throughthe endotracheal tube from escaping outwardly from the trachea.

Other advantages of the invention will be apparent from the followingdescription, the accompanying drawings and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

To provide a more complete understanding of the present invention andfurther features and advantages thereof, reference is now made to thefollowing description taken in conjunction with the accompanyingdrawings, in which:

FIG. 1 is a partial view showing the oral passageway of a patient forthe exchange of gasses between the lungs and the outside atmosphere andshowing the intubation device of the present invention partiallyinserted;

FIG. 2 is a side view of the intubation device of FIG. 1;

FIG. 3 is a side view of the intubation device of FIG. 1 showing thestylet in its unsheathed position within the endotracheal tube;

FIG. 4 is a rearward sectional view of the intubation device of FIG. 1with the stylet positioned in its sheathed position within theendotracheal tube and showing the stylet and the soft and pliableplastic sleeve;

FIG. 5 is a partial view showing oral intubation of a patient utilizingthe intubation device of the present invention with the stylet in itsextended position within the trachea;

FIG. 6 is a partial view showing oral intubation of a patient utilizingthe intubation device of the present invention with the endotrachealtube within the tracheal and the inflatable bladder inflated to preventventilation gas from flowing through the endotracheal tube from escapingoutwardly from the trachea;

FIG. 7 is a rearward sectional view of another preferred embodiment ofthe invention showing the inner wall of the endotracheal tube having aninner sleeve adapted for receiving the stylet;

FIG. 8 is a partial view of another preferred embodiment of theinvention showing the endotracheal tube and the stylet in its unsheathedposition and having a taper for minimizing the lip formed between theforward open end of the endotracheal tube and the stylet;

FIG. 9 is a forward end view of the stylet of FIG. 8;

FIG. 10 is a partial view of another preferred embodiment of theinvention showing the forward open end of the endotracheal tube having acuff for minimizing the lip formed between the forward open end of theendotracheal tube and the stylet;

FIG. 11 is a rearward sectional view of another preferred embodiment ofthe invention showing the stylet having a longitudinally extendinghollow core; and

FIG. 12 is a partial side view of the guide portion of the styletshowing the chemiluminesent light.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to a method of performing endotrachealintubation and a new and novel intubation device for performing themethod. In describing the preferred embodiments of the inventionillustrated in the drawings, specific terminology will be resorted tofor the sake of clarity. However, the invention is not intended to belimited to the specific terms so selected, and it is to be understoodthat each specific term includes all technical equivalents that operatein a similar manner to accomplish a similar purpose.

For purposes of the description of the present invention, the terms“forward” and “forwardly” are intended to refer to the direction towardsthe patient receiving the intubation device, whereas the terms “rear”and “rearwardly” are intended to refer to the direction away from thepatient receiving the intubation device.

Referring to FIG. 1, a partial cross-section of a patient P is shownillustrating the mouth 2, the epiglottis 4, the nasopharynx 6, theesophagus 8 that operates to transfer food to the stomach (not shown),the larynx 10, and the trachea 12 that operates to provide a passagewayfor the exchange of gasses between the lungs (not shown), the alveoli(not shown), and the outside atmosphere A.

Referring to FIG. 2, the intubation device 100 of the presentapplication is shown comprising an elongated endotracheal tube 102having a rearward open end 104 and a forward open end 106 having alongitudinal bore 108 there between. The endotracheal tube 102 is formedof a pliable semi-rigid, soft plastic material such as, but not limitedto, a polyethylene, a polypropylene, or like material. The lower forwardend of the endotracheal tube 102 includes one or more inflatablebladders or balloons 110 which is attached to an air device through anair line 112 such that when inflated the bladder 110 operates to preventventilation gas flowing through the endotracheal tube 102 from escapingoutwardly from the trachea 12 of the patient P. A portion of the airline 112 is preferably positioned within the wall of the endotrachealtube 102 and provides flow communication between the bladder 110 and anexternal air source (not shown). The rearward end 114 of the air line112 is provided with a flow valve 116 to permit a syringe (not shown) orother inflation device to be placed in flow communication with the airline 112 for injecting a predetermined amount of air into the bladder110.

The rearward open end 104 of the endotracheal tube 102 is provided witha fitting 118 having a neck portion 120 for inserting longitudinallywithin the rearward open end 104 and an adaptor 122 for connecting to arespirator or other ventilating apparatus or oxygen supply, anesthesiasupply, or some other medical gas supply.

Referring to FIGS. 2, 3 and 4, telescopically positioned within theendotracheal tube 102 is an elongated stylet 124 which is formed from asemi-flexible material that can be bent relatively easily into adesirable contour, such as AWG 6-14 cooper wire of a circular crosssection or some other suitable material that can be bent into a desiredcontour and rigid enough to support and help maintain the endotrachealtube 102 in a desired contour. The stylet 124 includes a soft andpliable plastic sleeve 126 formed from a plastic, such as apolyethylene, polypropylene, polyvinylchloride, or the like, or a rubbercomposition. The sleeve 126 covers the entire length of the stylet 124and extends longitudinally outwardly from the forward end of the stylet124 to form a soft, flexible and malleable guide portion 128. Therearward end of the stylet 124 extends longitudinally outwardly throughthe endotracheal tube 102 and fitting 118 such that medical personnelcan easily grasp the end of the stylet 124 during the intubationprocedure. In a preferred embodiment of the invention the rearward endof the stylet 124 can be curved or looped, as shown, or have a largercross section, or can include a collar or grip to provide a bettergripping surface for medical personnel. Preferably, the forward end ofthe endotracheal tube 102 and the stylet 124 are rounded or tapered tominimize trauma to the tissue of the patient's airway during insertion.

Referring to FIGS. 1, 5, and 6, in operation, the intubation device 100is first bent into the desired contour (step 1) that the medicalpersonnel believes approximates what is believed conforms to thepatient's air passage way to the trachea 12. The intubation device 100is then inserted into the patient's mouth 2 (step 2) such that theendotracheal tube 102 together with the stylet 124 are moved behind theepiglottis 4 past the esophagus 8 (FIG. 1) and towards the larynx 10. Inorder to aide in insertion of the endotracheal tube 102 and to avoidtrauma to sensitive throat tissue, after the forward end of theintubation device 100 approaches the larynx 10, the medical personnelmoves the stylet 124 forwardly such that the guide portion 128 moveslongitudinally outwardly from the endotracheal tube 102 and forwardlytowards and through the larynx 10 and into the trachea 12 (step 3) (FIG.5). It should now be apparent to those skilled in the art that byreducing the risk of tissue trauma often encountered with firstinsertion of an endotracheal tube 102 into a patient's trachea 12,tissue swelling around the trachea 12 is minimized allowing medicalpersonnel an unobstructed view of the larynx 10. After the guide portion128 of the stylet 124 has been properly inserted into the trachea 12,the endotracheal tube 102 is telescopically slid or moved forwardlyalong the stylet 124 and guide portion 128 through the larynx 10 andinto position within the trachea 12 (step 4) (FIG. 6).

Once the endotracheal tube 102 is in position within the trachea 12, airis injected through the flow valve 116, such as by a syringe, to inflatethe bladder 110 (step 5). The inflated bladder 110 then operates toprovide a seal to eliminate any gas that is being supplied by theendotracheal tube 102 from passing back out through the larynx 10.Medical personnel can then remove the stylet 124 (step 6) by retractingthe guide portion 128 rearwardly out through the larynx 10 and outthrough the rearward open end 104 and fitting 118. The endotracheal tube102 can then be connected using the adaptor 122 to a respirator or otherventilating apparatus or oxygen supply, an anesthesia supply, or someother medical gas supply. After use, the endotracheal tube 102 can beremoved by first releasing air from the bladder 110 by opening the flowvalve 116 and slowly withdrawing the endotracheal tube 102. Theintubation device 100 is disposable and can be discarded after use.

It should be understood that the endotracheal tube 102 and stylet 124can have a predetermined curvature to aide in the easy and quickinsertion of the intubation device 100. For example, as shown in FIG. 2,the endotracheal tube 102 and stylet 124 can have a first curvature,such as shown at C1, and a second curvature, such as shown at C2. Itshould now be understood to those skilled in the art, however, that theendotracheal tube 102 and stylet 124 can be formed into a variety ofcurvatures or molded by hand to a desirable curvature. It should alsonow be understood to those skilled in the art that during the insertionprocess, if necessary, the stylet 124 can be removed and its contouradjusted and reinserted into the endotracheal tube 102 thereby adjustingits contour.

Referring now to FIGS. 3 and 7, a rearward end sectional view of theanother embodiment of the intubation device 100 of the presentapplication is shown whereby the endotracheal tube 102 includes an innersleeve 130 (not shown in FIG. 3) that runs longitudinally along theinner wall 132 of the endotracheal tube 102 and is adapted for receivingstylet 124. In operation, the endotracheal tube 102 and stylet 124operate as previously described, but it should now be apparent to thoseskilled in the art that placement of the stylet 124 within the innersleeve 130 will permit the endotracheal tube 102 and stylet 124 to bebent into a desired contour with greater unity. In this way, theendotracheal tube 102 can be more easily bent and maintained in thedesired contour. It should be understood that the inner sleeve 130 maybe a singular unitary sleeve or may be formed from a plurality of cuffsand the like.

Referring to FIGS. 8 and 9, as shown, the stylet 124 in shown in itsunsheathed position. It should be understood to those skilled in the artthat during insertion of the intubation device 100, sharp edges mayresult in trauma to sensitive tissue. Accordingly, it is desirable tominimize the lip 132 formed between the endotracheal tube 102 and thestylet 124 when the stylet is in its unsheatherd position. In apreferred embodiment of the invention, the diameter of the forward endof the stylet 124 decreases in a forwardly direction towards the guideportion 128 forming a taper portion 134. As shown, when the stylet 124is extended in its unsheathed position, the taper operates to minimizingthe lip 132 formed between the forward open end 106 of the endotrachealtube 102 and the stylet 124.

Referring to FIG. 10, another preferred embodiment of the invention isshown whereby the forward open end 106 of the endotracheal tube 102includes and thin plastic or rubber membrane 136 forming a collar 138around the stylet 124. As shown, the collar 138 operates to minimize thelip 132 formed between the endotracheal tube 102 and the stylet 124.

Referring to FIGS. 1 and 11, a rearward end view of another embodimentof the present invention is shown whereby the stylet 124 has alongitudinally extending hollow core 140 that runs the entire length ofthe stylet 124 having a rearward first open end 142 and a forward secondopen end (not shown). The first end 142 of the stylet 124 is adapted toconnect to a standard oxygen supply (not shown) for ventilation. Duringoperation, once the stylet 124 is inserted into the trachea 12, oxygencan be immediately supplied to the patient P. The endotracheal tube 102can then be telescopically moved over the stylet 124 and into thetrachea 12. The stylet 124 can then be removed. It should be apparent tothose skilled in the art that the ability to inject oxygen through thestylet 124 can provide critically needed oxygen to the patient in theevent insertion of the endotracheal tube 102 meets with an unexpectedobstruction or resistance.

It should now be apparent to those skilled in the art that theintubation device of the present application can be easily adapted toaccommodate other various mechanisms known in the art to aide inintubation of a patient. One such mechanism is shown and described inU.S. Pat. No. 5,259,377 and is incorporated herein by reference wherebythe intubation device includes a mechanism comprising a flexible memberpositioned within the endotracheal tube that is operated by a handlemeans for inducing curvature to the endotracheal tube and stylet.Another such mechanism is shown and described in U.S. Pat. No. 6,539,942and is incorporated herein by reference whereby a control wire andhandgrip is provided to curve the endotracheal tube and stylet. Itshould be understood, however, that mechanisms for aiding in inducingcurvature of the endotracheal tube and stylet are not limited to theabove examples. In another preferred embodiment of the method of thepresent application, once the endotracheal tube 102 has been partiallyinserted into the air passageway of the patient P, if medical personnelfind that the endotracheal tube 102 and stylet 124 do not have theproper contour, they can be adjusted into the desired contour by theadjustment mechanism. It should also be understood that the endotrachealtube 102 can remain inserted into the air passageway of the patient Pand the stylet 124 removed and its contour adjusted into a desiredconfiguration and reinserted back into the endotracheal tube 102 toadjust its contour into the desired configuration.

Referring to FIGS. 1 and 12, another preferred embodiment of theinvention is shown whereby enclosed within the guide portion 128 of thestylet 124 is a vial 146 preferably formed from a pliable plastic,having a glass liner 148 containing a chemiluminescent light producingliquid reactant 150, such as bis (2, 4,5-trichloro-6-carbopentoryphenyl) oxalate and a fluorescer in fibutylphthalate. Positioned within the vial 146 is a sealed glass ampule 152having an oxidizer 154, such as an 85 percent solution of hydrogenperoxide in dimethyl phthalate and a catalytic quantity of catalyst,such as sodium salicylate. In operation, prior to insertion of theintubation device 100, medical personnel activates the chemiluminescentlight by bending or pressing the guide portion encompassing the vial 146such that the glass ampule 152 breaks to allow the oxidizer 154 to mixwith the reactant 150 thereby producing chemiluminescent light. In thisway direct illumination of the larynx 10 and trachea 12 will beobtained.

While the intubation device and method of the present invention has beenshown and described as being inserted into the patient's air pathway byway of the mouth, it should now be understood that the intubation devicemay also be inserted through the nose of the patient.

It should now be apparent to those skilled in the art that theintubation device of the present application can be quickly and easilyinserted to form an unobstructed conduit to a patient's trachea in whichoxygen, medications and therapies can be passed. It should also now beapparent to those skilled in the art that the intubation deviceeliminates or reduces the problems typically associated with inducershaving conventional metal stylets or the like because of the soft,flexible and malleable guide portion that reduces the likelihood oftrauma to the sensitive throat tissue. It should also now be apparent tothose skilled in the art that the intubation device of the presentinvention minimizes the lip formed between the endotracheal tube and thestylet thereby reducing the likelihood of trauma to sensitive tissue. Inaddition, the intubation device of the present application reduces thechances of compromising the sterility of the device, and which can berelatively inexpensive to manufacture. It should also now be apparent tothose skilled in the art that the intubation device is relatively easyto manipulate with one hand and allows for delicate control andsensitivity necessary to intubate a patient quickly with a minimumamount of trauma to sensitive tissue.

Although the foregoing invention has been described in some detail forpurposes of clarity of understandings, it will be apparent that certainchanges and modifications may be practiced within the scope of theappended claims. Furthermore, it should be noted that there arealternative ways of implementing both the method and article forimplementing the method of the present invention. Accordingly, thepresent embodiments and examples are to be considered as illustrativeand not restrictive, and the invention is not to be limited to thedetails given herein, but may be modified within the scope andequivalents of the appended claims.

1. An intubation device for use in medical intubation of a patientcomprising: an endotracheal tube having a forward open end and arearward open end and an inner bore there between; and a stylet slidablypositioned within said inner bore and having a rearward end, a forwardend, a longitudinally extending semi-rigid portion effective for bendingand maintaining the endotracheal tube in a desired contour, and alongitudinally extending elongated flexible guide portion; wherein, saidstylet is adapted to move outwardly from said forward open end of saidendotracheal tube towards the trachea such that during insertion of saidendotracheal tube into the trachea of the patient said guide portion iseffective for being positioned within the trachea and allowing saidendotracheal tube to slide forwardly along said elongated flexible guideportion of said stylet and into proper position within the trachea; andwherein said stylet comprises a tapered portion effective for reducingthe lip formed between said endotracheal tube and said stylet.
 2. Theintubation device of claim 1 further comprising at least one inflatablebladder for inflating and preventing ventilation gas flowing throughsaid endotracheal tube from escaping outwardly from the trachea.
 3. Theintubation tube of claim 1 wherein said stylet is formed from asemi-flexible metal rod.
 4. The intubation tube of claim 1 wherein saidstylet is formed from copper rod.
 5. The intubation device of claim 1wherein said stylet further comprises a soft and pliable plastic sleeve.6. The intubation device of claim 1 further comprising a light effectivefor illumination of the larynx and trachea of the patient.
 7. Anintubation device for use in medical intubation of a patient comprising:an endotracheal tube having a forward open end and a rearward open endand an inner bore there between; and a stylet slidably positioned withinsaid inner bore and having a rearward end, a forward end, alongitudinally extending semi-rigid portion effective for bending andmaintaining the endotracheal tube in a desired contour, and alongitudinally extending elongated flexible guide portion; wherein, saidstylet is adapted to move outwardly from said forward open end of saidendotracheal tube towards the trachea such that during insertion of saidendotracheal tube into the trachea of the patient said guide portion iseffective for being positioned within the trachea and allowing saidendotracheal tube to slide forwardly along said elongated flexible guideportion of said stylet and into proper position within the trachea; andwherein said endotracheal tube comprises a collar effective for reducingthe lip formed between said endotracheal tube and said stylet.
 8. Anintubation device for use in medical intubation of a patient comprising:an endotracheal tube having a forward open end and a rearward open endand an inner bore there between, said endotracheal tube is formed from apliable, semi-rigid, soft plastic material; a stylet positioned withinsaid inner bore and having a rearward end, a forward end, asemi-flexible portion and a longitudinally extending elongated flexibleguide portion, said guide portion is formed from a soft and flexiblematerial; wherein said semi-flexible portion is effective for placingand maintaining said endotracheal tube in a desired contour; andwherein, said flexible guide portion is adapted to extend outwardly fromsaid forward open end of said endotracheal tube such that duringinsertion of said endotracheal tube into the trachea of the patient saidguide portion is positioned within the trachea and operates to guidesaid endotracheal tube into proper position within the trachea; andwherein the stylet comprises a tapered portion effective for reducingthe lip formed between said endotracheal tube and said stylet.
 9. Theintubation device of claim 8 wherein said stylet further comprises asoft and pliable plastic sleeve.
 10. The intubation device of claim 8further comprising means for adjusting the contour of said endotrachealtube and said stylet while inserted into the patient.
 11. The intubationdevice of claim 8 further comprising a chemiluminescent light effectivefor illumination of the larynx and trachea of the patient.
 12. Anintubation device for use in medical intubation of a patient comprising:an endotracheal tube having a forward open end and a rearward open endand an inner bore there between, said endotracheal tube is formed from apliable, semi-rigid, soft plastic material; a stylet positioned withinsaid inner bore and having a rearward end, a forward end, asemi-flexible portion and a longitudinally extending elongated flexibleguide portion, said guide portion is formed from a soft and flexiblematerial; wherein said semi-flexible portion is effective for placingand maintaining said endotracheal tube in a desired contour; andwherein, said flexible guide portion is adapted to extend outwardly fromsaid forward open end of said endotracheal tube such that duringinsertion of said endotracheal tube into the trachea of the patient saidguide portion is positioned within the trachea and operates to guidesaid endotracheal tube into proper position within the trachea; andwherein said endotracheal tube comprises a collar effective for reducingthe lip formed between said endotracheal tube and said stylet.